Company :

    Contact Person :

                     Email :
        
                                    Full  Address :                                                      
      
             Telephone :

                         Fax :

  Liquid to be filled : Please Select Viscose Liquor Syrups Suspensions Pastes Paints Creams Shampoo Other

    Container MOC : Please Select Glass Pet Tin HDPE/LDPE Other

                    Shape : Please Select Round Eliptical Oval Square Triangle Dumpy Other

                        Size : Please Select 5 mls 10 mls 50 mls 100 mls Other

      Filling Machine : Please Select Volumetric NRV Volumetric RTV Vacuumetric Partial Vacuumetric Grandmetric Other

     Enclosure Type : Please Select ROPP Cap Screw Cap Other

         Packing Line : Please Select Automatic Semi-Automatic

                    Output : Please Select Bottles per minute Bottles per hour Bottles per shift     No. of Bottles :
                       
               Details of the requirement / your comments or specifications :